Our servicemen and women have to restart their lives upon returning home from battle. These new challenges can present circumstances far different from those of war. Facing these challenges head on can be daunting for many. Easing back into society can tough, especially for those who suffer from Post-Traumatic Stress (PTS) and Traumatic Brain Injury (TBI). According to the Veterans Administration (VA), between 11-20% of veterans during Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF) have been diagnosed with PTS in a given year.

There are a variety of ways to ensure that transition is as smooth as possible. One of those methods is pairing a Veteran with a service dog. Suffering from PTS can leave an individual feeling isolated from family and friends. Depression and other emotional disorders can surface as well. The method of service dogs is to provide the veteran with a companion trained to help them with basic needs. However, the animal is indirectly re-teaching the veteran how to care for someone, using emotions as communication, and even how to love.

“We think pet dogs, therapy animals and service animals all have a role to play in peoples’ health and veterans’ health. This is all good news. A cold nose is a powerful motivation to get up in the morning,” said Stave Feldman, executive director of the Human Animal Bond Research Institute Foundation. Mr. Feldman discussed studies between the animals and veterans to The Military Times in a recent article.

“He brought me back from the brink,” said Veteran Colonel Roger Lintz, (US Army – Retired) of his Service Dog – Niles. Living with PTS does take time to accept that life may not be the same. This veteran, who honorably served his country, was able to find true companionship with his new four legged friend. Niles was able to help him with remedial tasks around the house and would wake him from nightmares. These nightmares and other issues with PTS nearly became too much to handle. Col. Lintz believes that his companion saved his life when suicidal thoughts started to cloud his mind. Watch the full interview:

The American Psychology Association and The Society Military Psychology have found that this alternative method could help nearly 40% of veterans. Especially those who do not show signs of improvement after participating in treatments such as prolonged exposure (PE) and cognitive processing therapy (CPT), which are considered the “gold standard” for treating PTS.

Maj. Todd Olsen had participated in multiple tours of duty since enlisting in the Army in 1989. However, coming back after his last mission sent his life into a tailspin. He was suffering from multiple symptoms of PTS, rebuilding a relationship with his two boys, and filing for divorce from his wife.

Some servicemen and women will attend the actual trainings with their service dog. They get to watch them go through obstacle courses, learn commands, and how to save lives. This, in a way, gives the veteran a sense of purpose again. Their life and bond matter as much to the service dog as the service dog means to them.

Maj. Todd Olsen of Pennsylvania told The Daily Progress that, “It’s not so much training the dog, it’s training the veteran and then pairing them up together. So we weren’t teaching them basic obedience, we were learning the commands and the dogs were learning how we give the commands.”

There have been few in-depth studies about the dynamic between a service dog and PTS. However, The Veterans Administration believes that veterans can experience some needed benefits by owning an animal or being paired with a service dog. The VA also counsels that veterans should speak with their doctor and family before applying for a service dog.

What are the emotional benefits of having a dog?

Dogs can make great pets. Having a dog as a pet can benefit anyone who likes dogs, including people with PTS. For example, dogs:

Help bring out feelings of love

Do things that are different from natural dog behavior

Do things that the handler (dog owner) cannot do because of a disability

Learn to work with the new handler in ways that help manage the owner’s disability

Are good companions

Take orders well when trained. This can be very comfortable for a Servicemember or Veteran who was used to giving orders in the military

Are fun and can help reduce stress

Are a good reason to get out of the house, spend time outdoors, and meet new people

(Source: The Veterans Administration)

Maj. Todd Olsen continues his transition into “civilian life” by working with his service dog and attending yoga classes. He says, “With the yoga for veterans and the dog, and continuing treatment at the VA, it’s putting me back together.”

The Purple Heart Foundation has provided funds to service dog programs totaling $75,000 over the years. The Purple Heart Foundation remains committed to assisting veterans in all aspects of their lives, including service dog programs, other rehabilitative programs, and disability benefits. You can show your support for these brave men and women who have sacrificed so much for our country by making a one-time or monthly pledge to ensure veterans continue to get the support and benefits they deserve by clicking here.

September 1 marked the start of Suicide Prevention Month. Throughout the month, individuals and organizations have been raising awareness about different suicide prevention programs. Programs such as the Yellow Ribbon Suicide Prevention program, 22Kill, and Operation Never Forgotten all give support to those who are battling suicidal thoughts or actions and give them an outlet to share their frustrations. The Purple Heart Foundation also has a suicide prevention program to help those who may be contemplating suicide.

The topic of suicide can be a difficult topic to bring up, especially if you or someone you love is showing signs of possibly attempting to end their life. The most important thing to remember when having this conversation, according to Dr. Andrew Tomacari, is to show genuine support for the person during this tough period in their lives. Having a heartfelt conversation can help the person open up and start a conversation about how they’re feeling.

In 2014, the Department of Veterans Affairs reported an average of 20 veterans die from suicide each day, and six of the 20 used VA services. There is continued evidence, according to a July 2016 report that middle-aged and older veterans have a high burden of suicide. For families of veterans who have committed suicide, sharing their story can help other veterans who are thinking of ending their life. When Army veteran Daniel Somers committed suicide on June 10, 2013, he asked his wife to share the note he wrote to his family as she saw fit in order to raise awareness.

Holden Corzine, an Army Veteran of the War in Afghanistan ended his life on April 6, 2016. The 29-year-old suffered from PTSD after he came back from Afghanistan and sought out treatment. Even with the help he received, Holden struggled. Holden’s parents share his story in an effort to raise awareness, “My wife and I both thought if it helped one person, it was worth it. All we wanted people to do is get help, hang onto their loved ones, and let them know things would be OK,” Holden’s father Jhan said. “Sometimes that’s not enough.”

One of the reasons for the rate of suicide in the military is the stigma that military personnel need to be strong and not ask for help.“In the past, it was an unwritten rule (in the military) that it was frowned upon if you sought help with (mental illness),” said Chip Tansill, a retired Army colonel and combat veteran and director of the Ohio Department of Veteran Services.

People like the Corzine family and others around the country are trying to raise awareness to help bring down the statistics of veteran suicide. Some of the ways in which people are helping to raise awareness include:

Navy veteran and father Marc Herzog of Westfield, NJ marched 13 miles with non-profit organization Irreverent Warriors to raise awareness.

The #22PushUpChallenge and #22KILL hashtag has taken the nation by storm with everyone from regular citizens to celebrities to Olympians completing 22 pushups for 22 days straight in honor of the estimated amount of veterans committing suicide each day.

During the month on Twitter, the hashtag #BeThere has been used to show that even just being there for a person over the phone or face-to-face can make a difference to someone in crisis and help them get the help they need.

The main theme for this year’s awareness programs and event is being there for someone. Whether it be through a phone call, text message, or sharing a meal with someone, letting them know that they are not alone in their fight may give them the reassurance they need to seek out help.

The fight to end veteran suicide has come to Capitol Hill as well. Sen. Joni Ernst, (R-Iowa), who is a former Lieutenant Colonel in the Iowa Army National Guard, introduced legislation on the topic. Ernst introduced to the Senate the Prioritizing Veterans’ Access to Mental Health Care Act. The proposal included an option for veterans seeking help to look outside of the Veterans Affairs.

She also introduced the Female Veteran Suicide Prevention Act to help reduce the number of female veteran suicides. According to the most recent Veterans Affairs study, female veterans are six times more likely to commit suicide than non-female veterans. The bipartisan legislation, also championed by Democratic senator Barbara Boxer, was signed into law by President Obama in July.

Being available to listen and speak with someone who may be considering taking their life is important. By having heartfelt talks about what they need, the person struggling will hopefully be able to see that they don’t have to fight alone and there are resources available to get them the help they need. One major resource is the Suicide Prevention Hotline. If you or someone you know may be thinking of committing suicide, call 1-800-273-5255 24 hours a day, seven days a week.

The Purple Heart Foundation is committed to assisting veterans in all aspects of their lives, including helping those who are struggling with thoughts of suicide through our suicide prevention program. Show your support for these brave men and women in their fight against suicide by making a one-time or monthly pledge to ensure veterans continue to get the support and benefits they deserve by clicking here.

From cross-country bikes to cross-country walks with the American flag, veterans across the country are going to great lengths to raise awareness about post-traumatic stress disorder (PTSD). Some veterans have taken to sharing their accounts of living with PTSD. In the wake of PTSD Awareness Day on June 27, here are their stories and how they turned their lives around.

Michelle Fisher

After returning from Iraq, Staff Sergeant Michelle Fisher was pulled over while she was driving one night. She passed all the field sobriety tests, but failed the breathalyzer test, blowing a 0.182. The police officer initially thought his breathalyzer was broken, due to her shockingly high level of motor control function. She knew she needed help after that.

Treatment helped her confront her drinking problem, a side effect of the PTSD. Fisher began to overcome the little things, like sitting next to a stranger and leaving the house. She also strengthened the bond with her partner in the process. Read more.

Arthur Jefferson

Staff Sergeant Arthur Jefferson didn’t initially think he had PTSD, believing it only affected veterans “actually in the war,” like Vietnam, World War I, and World War II. He first noticed the night sweats that prevented him from falling back asleep. Jefferson also distanced himself from people, avoided going to crowded places, and felt uncomfortable around non-military people and places.

After receiving treatment, Jefferson improved his relationship with his family and was able to venture outside of his comfort zone. He became in control of his PTSD and advises others to do the same. Read more.

Penny Anderson

Sergeant Penny Anderson became a different person after returning from deployment. She evolved from a happy and kind person to one who was angry, mean and isolated. She felt like a burden to her family and avoided certain people and places that triggered her trauma.

Plagued with suicidal thoughts, Anderson knew she had to make a change. Treatment helped her return to her happy self. She was able to regain her life back and truly live life to the fullest after receiving help. Read more.

Rob Tucker

On May 19, 2010, Specialist Rob Tucker woke up at four in the morning to the sound of an AK-47 firing only 200 yards from where he slept. Now, hearing a small bump at night is enough to startle him, and he sleeps with a gun by his head.

Tucker began receiving treatment for his PTSD and urges others to do the same. “If you don’t want to go, nobody can force you… But if you don’t go, you’re gonna be struggling like this for the rest of your life. If you’re struggling, ask for help. It’s there, and it’s free.” Read more.

If these stories sound familiar and you or someone you may know has been exposed to a life-threatening event or severe trauma, you may have PTSD. Although it affects everyone differently, common symptoms include trouble sleeping, recurring nightmares or memories of the trauma, anger or irritability, difficulty leaving the house, and more.

PTSD is not something you have to live with. There are a variety of treatment options and professionals who will work with you to determine the best fit. If you or someone you know is suffering from PTSD, don’t be afraid to get help.

The Purple Heart Foundation has been committed to offering assistance to those men and women who have served our country and struggle with PTSD. They offer an array of resources on the website and a number of resources. It is with the generous support of our supporters that we are able to continue offering this support to our nation’s heroes. To find out how you can get involved supporting our Veterans, visit The Purple Heart Service Foundation website for more information.

Often referred to as the signature injury of the Iraq and Afghanistan wars, the prevalence of traumatic brain injury (TBI) among veterans is higher than it’s ever been. The most common cause of TBI among Operation Enduring Freedom and Operation Iraqi Freedom service members is injuries suffered from Improvised Explosive Devices, or IEDs, used extensively against Coalition Forces.

Many people who sustain a Traumatic Brain Injury recover completely. However, in severe cases, a traumatic brain injury can cause emotional and behavioral changes that can be difficult to understand and accept.

A traumatic brain injury affects the entire family and often results in financial challenges, job loss and isolation. In the United States, 1.7 million people sustain a TBI each year. Whether you have suffered a TBI or are caring for someone who did, understanding you’re not alone is critical, the best thing you can do is reach out.

Join a group.

Meeting in person with other people with similar experiences can be cathartic. There are several places to find groups in your area.

When you can share your story and hear the stories of others, you realize there are people out there who understand what you’re going through, who can commiserate, or help put things in perspective. Luckily, the internet makes sharing easier than ever.

Brainline Military is an organization that serves the military community providing information, resources, and support for current and former service members and their families living with traumatic brain injury. Read the personal stories of military members living with TBI, and share your own.

A quick search for “Facebook TBI support group” turns up a handful of pages where you can connect on Facebook and be part of the conversation.

Get informed.

Knowing about traumatic brain injury—the symptoms, treatment options, and benefits you’re eligible for as a veteran or active duty military—will allow you to thrive, not just survive with this condition.

In WWI it was called Shell Shock; in WWII, Battle Fatigue. Korean War veterans were diagnosed with War Neurosis, and Vietnam vets with Post-Vietnam Syndrome. Whatever you call it, Post Traumatic Stress (PTS), as it’s now known, continues to affect hundreds of thousands of veterans.

Today is PTSD Awareness Day, a day to speak up about post-traumatic stress, a condition that’s underreported, misdiagnosed, and, so often, misunderstood.

PTS BY THE NUMBERS:

10-13% of combat veterans experience post-traumatic stress in their lifetimes.

Studies estimate that 1 in 5 military personnel returning from Iraq and Afghanistan has PTS.

PTS affects to 20% of Operation Enduring Freedom and Operation Iraqi Freedom veterans; 10% of Gulf War veterans, and 30% of Vietnam War veterans.

17% of combat troops are women; 71% of female military personnel develop PTS due to sexual assault within the ranks.

The number of diagnosed cases of PTS in the military jumped 50% in the past year.

SEPARATING MYTH FROM FACT

The psychological scars of post-traumatic stress may be invisible, but its manifestations are not. Left untreated, it can lead to depression, drug and alcohol abuse, or suicide. Despite its prevalence, post-traumatic stress is often ignored, misinterpreted, and sensationalized by the media.

Listening to the stories of veteran experiencing post-traumatic stress can help us separate myth from fact.

MYTH: People begin experiencing PTS immediately after a traumatic event.

FACT: Sometimes symptoms surface months or years after a traumatic event or returning from deployment.

“ I was sober and clean almost 11 years, and I just couldn’t handle it no more, you know, my life. I couldn’t hold a job. I always had problems sleeping…very irritable, the whole bit. Plus, my family was always telling me I should go get some help.”

FACT: When people seek help and maintain a treatment program, post-traumatic stress symptoms can be managed or overcome entirely.

“My ability to overcome the situations that cause me to act negatively and not beneficial to me, are up to me, and I continue to seek treatment. I want to make a choice, not have my depression make the choice.”

FACT: PTS is a physiological reaction to a traumatic or life-threatening situation.

“I also had the macho beliefs that if I admitted something was wrong, then I was defective. I was worried about how other people would interact with me, the labels I would carry the rest of my life, all kinds of nonsense. But as I got the help, the thing I learned is that every individual is a human being, and they can only take so much.”

FACT: There are three main groups of symptoms associated with post-traumatic stress, one of which is called hyperarousal— a tendency to be angry, irritable, on edge, and/or easily startled. However, studies indicate that PTS doesn’t inevitably lead to violence, and many people with PTS experience entirely different signs and symptoms, like avoidance and numbing or re-experiencing the traumatic event.

“Sometimes I can’t really leave my house…I love to work out. Working out is fun!…But the idea of being around people at the gym, especially if I get off work and I’ve already had to deal with people all day and be around people, then go to the gym, and being around people again is too overwhelming. Because people are going to be in my space.They might touch me. I have to be aware of who’s behind me, where the exits are. It’s exhausting.”

In WWI it was shell shock, in WWII battle fatigue. Korean War veterans were diagnosed with war neurosis and Vietnam veterans with post-Vietnam syndrome.

Whatever you call it, Post Traumatic Stress (PTS), as it’s now known, has affected soldiers for centuries, with symptoms ranging in severity from insomnia and nervousness to nightmares and debilitating social anxiety.

There’s nothing black and white about PTS, making it difficult to diagnose and challenging to treat. Compounding the problem, there is a lingering stigma around the condition, at least among service members, who would probably call it combat stress instead of PTS, explains former marine Michael Andrews.

He attributes his PTS symptoms less to one traumatic event and more to the overall experience of combat—deploying six consecutive times and grieving the death and injuries of many friends.

“Every time service members deploy, we have to put together casualty packets, which include directions from the nearest airport to our next-of-kin’s residence, a will, and even an obituary,” Andrews says.

He says, this, in addition to talking with loved ones about your potential death, takes its toll and has a lasting effect.

“PTSD is not like being pregnant. Pregnancy is a yes/no, binary equation; either you are or you aren’t. PTSD is like being overweight. Most of us have a couple pounds we can do without, but some people are 500 pounds overweight, and it’s going to kill them any day now.”

Despite the vast gray area, issues associated with PTS affect 7.7 million adults in the United States, mostly veterans. But, there is hope and help.

Here are some organizations working hard to help people with PTS and their families.

afterdeployment.org shares mental wellness resources for service members, veterans, and military families on topics like PTS, traumatic brain injury, suicide prevention and much more.

National Resource Directory is a web portal that connects wounded warriors, service members, veterans, their families and caregivers with support services.

Real Warriors Campaign is a multimedia public education campaign that encourages service members and veterans with invisible wounds to seek help. In addition to raising awareness, the campaign provides resources to help overcome barriers to care for invisible wounds, like PTS and traumatic brain injury.

WarriorCare.mil is a blog that provides wounded, ill, injured and transitioning service members information on programs, initiatives and support.

In a dangerous situation, it’s natural and healthy to feel afraid. Even after a traumatic experience, it’s common to feel frightened, sad, anxious, and disconnected. But when these symptoms persist, and the feelings of fear and helplessness don’t subside, it may be post-traumatic stress, a condition that can occur after living through a harrowing experience.

Many veterans returning from combat experience post-traumatic stress, often referred to as PTSD, or PTS.

According to experts:

Records of PTS exist from over 2,500 years ago.

7.7 million people are affected by PTS.

11-20% of veterans of the Iraq and Afghanistan wars suffer from PTS.

10% of Gulf War veterans suffer from PTS.

30% of Vietnam veterans suffer from PTS.

Post-traumatic stress is hard to diagnose because it doesn’t always appear immediately. Depending on the individual, it can take weeks, months, or even years before symptoms appear.

So, how can you tell the difference between a normal response to trauma and post-traumatic stress? There are three main symptoms associated with post-traumatic stress.

Re-experiencing the traumatic event

Intrusive, upsetting memories

Flashbacks

Nightmares

Intense distress when reminded of the trauma

Intense physical reactions to reminders of the event, like a pounding heart, rapid breathing, nausea, or sweating.

Avoidance and numbing

Avoiding activities, places, thoughts, or feelings that remind you of the trauma

Inability to remember important aspects of the trauma

Loss of interest in activities and life in general

Feeling detached from others and emotionally numb

A sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Increased anxiety and emotional arousal

Difficulty falling or staying asleep

Irritability or outbursts of anger

Difficulty concentrating

Feeling overly vigilant and anxious

Feeling agitated and easily surprised

Other common symptoms

Anger and irritability

Guilt, shame, or self-blame

Substance abuse

Feelings of mistrust and betrayal

Depression and hopelessness

Suicidal thoughts and feelings

Feeling alienated and alone

Physical aches and pains

Regardless of the initial trigger or when these issues begin, it’s important to seek help immediately. The good news is our understanding of post-traumatic stress is increasing. You are not alone. PTS can be successfully treated and overcome.

If you experience symptoms of post-traumatic stress, here’s what you can do:

Seek the support of a counselor at a military base or VA hospital.

Let us connect you with a National Service Officer near you. Find out more

Find some companionship though Canines for Combat Vets, a service dog program run by the nonprofit organization NEADS

Take care of yourself by eating nutritious foods, exercising regularly, relaxing, and avoiding drugs and alcohol.